Blood Pathology Pt 1: Anemia and Leukemia Flashcards Preview

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Flashcards in Blood Pathology Pt 1: Anemia and Leukemia Deck (72):
1

2 major parts of a complete blood count

mcv - mean corpuscular volume
mchc - mean corpuscular Hb concentration

2

"-cytic"

refers to cell size (mcv)

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"-chromic"

refers to cell color/amount of Hb (mchc)

4

anisocytosis

size variation

5

poikilocytosis

shape variation

6

anemia

reduction below normal in Hb or rbc number

7

causes of anemia

blood loss
excessive rbc destruction
insufficient rbc production

8

signs of destruction in hemolytic anemia

increased bilirubin, increased LDH, reduced haptoglobin

9

signs of production in hemolytic anemia

increased reticulocytes, nucleated red cells in blood

10

glucuronyl transferase

makes unconjugated bilirubin+albumin soluble by adding a sugar
is then excreted to the small intestine then feces

11

urobilinogen

made in the gut from bilirubin
can be excreted in feces or reabsorbed in blood
liver can metabolize it into bile

12

causes of jaundice

excess bilirubin production
decreased bilirubin excretion

13

t/f. bilirubin is toxic to brain cells

true

14

treatment of jaundice

treat cause, blood transfusion, sun

15

extrahepatic obstructive jaundice

light/clay colored feces, dark urine
obstruction of bile duct

16

intrahepatic obstructive jaundice

normal/light colored feces, light urine
damaged hepatocytes

17

hemolytic anemia

dark feces and urine

18

microangiopathic hemolytic anemia

extracorpuscular hemolytic anemia
shistocytes (rbc fragment)
causes - artificial heart valve, malignancy, obstetric complications, sepsis, trauma

19

autoimmune hemolytic anemia

extracorpuscular hemolytic anemia
warm (igG, spleen, spheocytes)
cold (igM complement, intravascular hemolysis, agglutination)

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sickle cell anemia

intracorpuscular hemolytic anemia
sickles clog vessels and are fragile
aa substitution in beta chain
african ethnicity
infarcted spleen with HbS

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thalassemia

intracorpuscular hemolytic anemia
increased rbc synthesis
alpha chain (SE asian)
beta chain (mediterranean)

22

hereditary spheocytosis

intracorpuscular hemolytic anemia
SPHEROCYTES
treatment - spenectomy

23

howell-jolly bodies

evidence of markedly decreased splenic function

24

g6pdh deficiency

intracorpuscular hemolytic anemia
ros exposure will kill rbcs
removal of heinz bodies (bite cells)

25

heinz bodies

globin denatures, sticks to rbc membrane

26

iron deficiency

microcytic, hypochromic anemia
atrophic glossitis/koilonychia
causes:
decreased iron intake
increased iron loss
increased iron requirement

27

anemia of chronic disease

normochromic, normocytic anemia
causes:
disrupted iron metabolism

28

megaloblastic anemia

normochromic, macrocytic anemia
causes:
reduced b12/folate in the body (insufficient intrinsic factor)
PERNICIOUS ANEMIA

29

what do blood contents look like in megaloblastic anemia?

large, oval shaped rbcs
hypersegmented neutrophils

30

schilling test

tests b12 absorption for pernicious anemia
stage 1 - feed labeled b12, inject b12
if abnormal (less than 10% in urine proceed to stage 2)
stage 2 - feed labled b12+IF
if b12 normal, patient has PA
if b12 reduced, patient has gi pathology

31

aplastic anemia

normochromic, normocytic anemia
hypoplatic (empty) bone marrow
pncytopenia - compromised immune function
causes:
idiopathic, drugs, viruses, pregnancy, fanconi anemia

32

myelophthisic anemia

normochromic, normocytic anemia
causes:
infiltration of bone marrow by tumors or fibrosis
tear drop shaped rbcs

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leukocytosis

wbc count above normal range

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neutrophilia

benign leukocytosis
mature and immature

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mature neutrophilia

highly segmented
causes: bacterial infection, inflammation, stress
toxic changes: granulation, dohle bodies, vacuolization

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immature neutrophilia

not segmented
causes: infection, inflammation, severe anemia, marrow displacement
3 forms

37

3 forms of immature neutrophilia

left shift (more immature than mature wbcs)
leukemoid reaction - elevation in leukocytes in response to stress or infection
leukoerythroblastic reaction - same as leukemoid but with nucleated rbc

38

lymphocytosis

benign leukocytosis
mature and reactive

39

mature lymphocytosis

lots of normal cells
causes: infectious lymphocytosis, bordatella pertussis, transient stress

40

reactive lymphocytosis

lots of abnormal cells
causes: mono, pediatric viral infections, viral hepatitis, immune disorders (downey cells)

41

basophilia

benign leukocytosis
uncommon
component of chronic myelogenous leukemia

42

monocytosis

benign leukocytosis
causes: infection, autoimmune disease, malignancy

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eosinophilia

benign leukocytosis
causes: drugs, asthma, skin diseases, parasites

44

differences between leukemia and lymphoma

leukemia - starts in bone marrow, can spread to blood nodes, myeloid or lymphoid, acute or chronic
lymphoma - starts in lymph nodes, can spead to blood, marrow, lymphoid only, hodgkin or non hodgkin

45

acute

sudden onset
occurs in children and adults over 60
rapidly fatal w/o treatment
immature cells (blasts)

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chronic

slow onset
only in adults
longer course
mature cells

47

acute leukemia

malignant proliferation of immature myeloid or lymphoid cells in bone marrow

48

acute leukemia causes

clonal expansion
maturation failure

49

acute leukemia symptoms

fatigue
infections
bleeding
bone pain
lymphadenopathy

50

lethality of acute leukemia

inhibition of normal cell function
infiltration of organs

51

acute myeloid leukemia

malignant proliferation of myeloid blasts in blood and bone marrow
many subtypes
bad prognosis
in adults

52

auer rods

AML-M3
clumps of granular material that form elongated needles in the cyto of the leukemic blasts

53

which subtype of acute myeloid leukemia results in a shortage of blood platelets?

aml-m5

54

which subtype of acute myeloid leukemia results in multinucleated erythroblasts?

aml-m6

55

treatment of aml

chemotherapy
bone marrow transplant

56

acute lymphoblastic leukemia

malignant proliferation of lymphoid blasts in blood and bone marrow
common in children
good prognosis
classified by B vs T

57

t lineage all

bad prognosis

58

b lineage all

b cell precursor all = better prognosis
b cell all = bad prognosis

59

treatment of all

chemotherapy
bone marrow transplant

60

chronic leukemia

malignant proliferation of mature myeloid or lymphoid cells in the bone marrow

61

causes of chronic leukmia

clonal expansion
functional failure

62

symptoms of chronic leukemia

weight loss
fatigue
infections
bone pain
similar to acute but MORE GRADUAL

63

lethality of chronic leukemia

inhibition of normal cell funtion
infiltration of organs

64

chronic myeloid leukemia

neutrohpilic leukocytes
basophilia
PHILADELPHIA CHROMOSOME
three phases (chronic, accelerated, blast)

65

treatment of cml

imatinib, used to be bone marrow transplant

66

prognosis of cml

can be longer than 5 years

67

chronic myelofibrosis

panmyelosis (form of myeloid metaplasia
advancing to marrow fibrosis
extramedullary hematopoiesis
teardrop rbcs

68

polycythemia vera

high hemocrit
can cause hypertension

69

essential thrombocythemia

high platelet count

70

chronic lymphocytic leukemia

malignant proliferation of lymphocytes in the blood and bone marrow
MOST COMMON LEUKEMIA
only in adults
long course
little/no pain mostly incurable
cd5+ b cells (cannot produce antibodies)

71

treatment of cll

treat infections

72

prognosis of cll

monitor wbc counts
9 years